Positive Developments for 2026
The company expects 2026 to be a strong stepping stone with enhanced financial data pipeline ramping to 80% in membership and Part D exposure potentially moving below 30%. They foresee improved forecasting, lower volatility, and significant internal and market-driven tailwinds.
Operating Cost Reductions
agilon Health has reduced operating costs by $30 million and expects further savings in 2026 through strategic realignment, centralization of functions, and alignment with PCP partners.
Strong ACO REACH Performance
The ACO REACH program performed ahead of expectations with an adjusted EBITDA of $18 million, demonstrating the value agilon can deliver and shaping the transformation of their MA business.
Enhanced Stars Ratings
Approximately 75% of agilon members are expected to be in 4+ Star plans in 2027, an increase from 71% in the 2026 payment year, which supports better payer economics.
Clinical Program Success
The heart failure pathway reduced new inpatient heart failure diagnosis rates from 18% in 2024 to 5% in 2025. Virtual pharmacy solutions led to 30-day readmission rates falling below 5% compared to the national average of 20%.